Provider Demographics
NPI:1265457162
Name:BERRYMAN, RICHARD ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLAN
Last Name:BERRYMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 1/2 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3725
Mailing Address - Country:US
Mailing Address - Phone:603-224-2555
Mailing Address - Fax:603-226-3029
Practice Address - Street 1:20 1/2 S STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3725
Practice Address - Country:US
Practice Address - Phone:603-224-2555
Practice Address - Fax:603-226-3029
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice